Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by many conditions that affect maternal and feto-placental units, several sociocultural, religious, and geographical factors cannot be ignored. Considering this, the present study was conducted in a tertiary hospital in Khammam, Telangana to determine the average birth weight in normal pregnancy at term.Materials and Methods: All the babies, born following normal pregnancy from January 2013 to June 2015, were included in this study to establish their birth weight. Babies born without being affected by any factor influencing fetal weight were considered for the study. Some exclusion criteria such as short maternal height and teenage pregnancy were considered in this study.Results: There were 633 cases in the study group, out of which 226 were primipara and 407 were multipara. Average birth weight for all cases was 2790 g. Average birth weight for the first born babies was 2770 g, whereas in later born, it was 2800 g. Average birth weight of male newborn babies was 2860 g, whereas it was 2710 g for female newborn babies.Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana.

There several factors that predict the future growth pattern of a newborn baby. However, one of the most important factors is the birth weight, which can easily predict the survival, future development, and growth pattern of the newborn baby. Hence, it is a common query from the parents at the first instance to know the birth weight of the newborn. This is the only aspect where the parents want their offspring to be of average weight. Both low as well as high birth weight has its own complications, either immediate or late or both. Birth weight is affected by many factors. Not only abnormal conditions during pregnancy but genetic factors, ethnicity, religion, geographical distribution, and social traditions may also affect the newborn birth weight. Knowledge of normal is necessary to diagnose abnormality. In India, being a subcontinent, all the factors vary across different geographical regions. Hence, one statistical factor for the entire country should not be considered because it may not be sufficient to predict any complication. With this view in mind, the present study was carried out in Mamata General Hospital (MGH), Khammam, Telengana state, India. It is a tertiary care centre, affiliated to Mamata Medical College, Khammam, where most of the patients are from rural Telangana. Almost all patients belong to low socioeconomic status. They are either illiterate or with an exposure to primary to middle school education. Most of them are daily labourer in farming sector or housewife by profession.

This is a retrospective study. The study was carried out with an aim of:

Estimation of birth weight of the newborn delivered at term following normal pregnancy in order to obtain a standard birth weight reference range in Telangana region of South India

Comparison of average birth weight of male and female babies

Estimation of average birth weight in firstborn and that of later born babies

Comparison of the abovementioned statistics with available national and other regional studies.

Materials and Methods

Birth weight of babies delivered in Mamata General Hospital, Khammam, from January 2013 to June 2015, at term (>37 weeks of gestational age) following normal pregnancy were included in this study. Babies born without being affected by any factor influencing the fetal weight were considered for the study. The study group included only live births delivered vaginally, assisted, or by cesarean section. All the mothers in the study group were without any risk factors.

The gestational age of complete 37 weeks was strictly adhered in this study group. Gestational age was determined by Last Menstrual Period (LMP) and ultrasound-based evidence.

Average birth weights for all such deliveries were taken. Average birth weights for male and female babies were calculated separately. Average birth weight in primipara and multipara was found out. All three data were compared with that of the other available studies.

Results

Being a tertiary care centre, majority of deliveries were high risk pregnancy. Total number of deliveries fulfilling the specified criteria after excluding the risk factors was 633 during the specified period. All the patients belonged to low socioeconomic status. They were either illiterate or with an exposure to primary to middle school education. Most of them were daily labourer in farming sector or house wife by profession.

All the mothers were between the age group of 20 to 31 years (mean age group = 25.5 years). Therefore, the relation of maternal age and newborn birth weight was not considered in the present study.

Out of the 633 participants, 226 (35.7%) were primigravidae, whereas 407 (64.3%) were multiparas. The gestational age (GA) in the study group was between 37–42 weeks. The maternal height was 151–158 cm.

Average birth weight for the abovementioned deliveries was found to be 2790 g. A total of 538 babies (85%) were having birth weight >2500 g, whereas 95 babies (15%) were weighing <2500 g. There were 343 male babies (54.2%) with an average birth weight of 2860 kg, whereas 290 female babies (45.8%) were born with an average birth weight of 2710 grams. The male babies were found to have 150 g more weight than their female counterparts.

Average birth weight was 2770 g in the babies born to first born group (n = 226), whereas in later born group (n = 407), average birth weight was 2800 g. There was no significant difference in birth weight between first born and later born babies [Table 1]. There was no case beyond the third live baby.

As stated by the World Health Organization (WHO), baby weighing <2500 g is low birth weight. Numerous reference standards have been advocated by many workers to establish birth weight. However, the globally developed standards, which have been used by researchers, are recently found to decline in their use due to availability of local standards, which are specific to a particular country or region.[1],[2],[3] The basic limitation of these standards is that they do not rule out the maternal and fetal risk factors when calculating the average birth weight. Though no study was found from the region of Telangana, some data from other parts of India are available regarding the birth weight of the newborn. However, most of these studies have not excluded the risk factors, which have a significant influence on the normal birth weight of newborn babies born in normal pregnancy at term. Ashtekar et al. in a retrospective study in Nasik, Maharastra, found the average birth weight to be 2.71 kg.[4] However, there was no consideration for gestational age or factors affecting birth weight. A study from south India, Ambedkar district (rural) in Tamil Nadu conducted by Antonisamy et al. found the average birth weight to be 2.77 kg.[5] They also did not consider the exclusion criteria like the present study. Bisai et al. in their study from Kolkata found it to be 2.64 kg.[6] The only criterion used by them was maternal second trimester weight. Alexander et al. found the average birth weight in rural South India population, excluding factors in mothers affecting birth weight. However, they did not exclude multiple gestations, and gestational age of 32 weeks to 42 weeks was considered. Average birth weight in their study was 2700 g in 2003 to 2900 g in 2012.[7] Kumar et al. in a South Indian tertiary teaching hospital among 19501 cases published their data on new birth weight standards in a South Indian population.[8] In their study, they considered cases without any risk factors like the present study. However, unlike the present study, where only cases at term (>37 weeks gestational age) have been considered, they have taken all the cases between 24 to 42 weeks of gestational age in their study. In their study, they found that first born babies born at term had a mean weight of 2934 g for male babies, whereas female babies had a mean birth weight of 2889 g. Male babies weighed 45 g more than the female babies. In later born babies, the figures were 3085 g and 2969 g respectively, with a weight difference of 152 g. In the present study, the mean birth weight for male babies was 2860 g, whereas for female babies it was 2710 g, with a weight difference of 150 g. For first born babies, the mean weight was 2770 g, whereas it was 2880 g for later born babies, with a weight difference of 110 g. In another study in South India, Mathai et al. have shown that female babies were lighter by 113 g than their male counterparts.[2]

As per the NFHS data, published in 2007, the average national low birth weight (LBW) babies born with <2500 g of weight was 22%. However, there was a wide regional variation, e.g., 8% in Mizoram, 22% in Maharashtra, 23% in rural areas, and 19% in urban areas.[9] In a study in Nanded, Maharastra, Jain et al. found out a high incidence (46.5%) of LBW babies born at term.[10] In a South Indian metropolitan city such as Bengaluru, LBW was found to be 25.8% with mean birth weight of 2775 g by Srikrishna and Stephan in 2003.[11] However, in these studies, risk factors have not been excluded. In the present study, the incidence of LBW babies born at term to mothers without any risk in Telangana was found to be 15%.

Difference between male and female baby birth weight has been determined by different study groups. However, none of the studies showed adequate information to reduce the error. Ashtekar et al. did not find any influence of sex of the baby on birth weight.[4]

Conclusion

Birth weight is a major determinant of child's health and nutrition. Both the extremes of under or over weight increases the risk of morbidity and mortality, either immediately or later. Determination of average birth weight for geographical region as well as sociocultural groups helps in predicting and managing such complications. In future, the data from this study may help the researchers in this field to consider this data as a reference point while pursuing research related to birth weight and various factors influencing it in this part of the country.